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Pediatric appointments

Ruth E K Stein, Ellen J Silver, Marilyn C Augustyn, Nathan J Blum, Pamela High, Nancy J Roizen
BACKGROUND: It is unknown how insurance status affects elements of evaluation at developmental behavioral (DB) pediatric sites. OBJECTIVE: To compare DB referrals, evaluation, and treatment for children with Medicaid and private insurance. DESIGN/METHODS: Fifty-six developmental behavioral pediatricians at 12 sites recorded anonymous data on structured forms for ≤15 consecutive referrals. Children with Medicaid (n = 309) and private insurance (n = 393) were compared on sociodemographic factors, referral concerns, evaluation elements, and resulting diagnoses...
March 19, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
Daphna Mezad-Koursh, Amir Rosenblatt, Hadas Newman, Chaim Stolovitch
PURPOSE: To evaluate the efficacy of the BinoVision home system as measured by improvement of visual acuity in the patient's amblyopic eye. METHODS: An open-label prospective pilot-trial of the system was conducted with amblyopic children aged 4-8 years at the pediatric ophthalmology unit, Tel-Aviv Medical Center, January 2014 to October 2015. Participants were assigned to the study or sham group for treatment with BinoVision for 8 or 12 weeks. Patients were instructed to watch animated television shows and videos at home using the BinoVision device for 60 minutes, 6 days a week...
March 16, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Albert C Hergenroeder, Douglas S Moodie, Daniel J Penny, Constance M Wiemann, Blanca Sanchez-Fournier, Lauren K Moore, Jane Head
OBJECTIVE: To describe changes in functional status between the last pediatric and first adult congenital heart disease (CHD) clinic visits in patients with moderate to severe CHD after implementing a healthcare transition (HCT) planning program. DESIGN: Quasi-experimental design. Patients were followed prospectively following the implementation of the intervention; Control patients transitioned from the Pediatric CHD Clinic into Adult CHD Clinic before the intervention...
March 15, 2018: Congenital Heart Disease
Mackensie A Yore, Matthew C Strehlow, Lily D Yan, Elizabeth A Pirrotta, Joan L Woods, Koy Somontha, Yim Sovannra, Lauren Auerbach, Rebecca Backer, Christophe Grundmann, Swaminatha V Mahadevan
BACKGROUND: Emergency medicine is a young specialty in many low- and middle-income countries (LMICs). Although many patients seeking emergency or acute care are children, little information is available about the needs and current treatment of this group in LMICs. In this observational study, we sought to describe characteristics, chief complaints, management, and outcomes of children presenting for unscheduled visits to two Cambodian public hospitals. METHODS: Children enrolled in the study presented without appointment for treatment at one of two Cambodian public referral hospitals during a 4-week period in 2012...
March 13, 2018: International Journal of Emergency Medicine
Megan H M Kuba, Byron H Izuka
BACKGROUND: Previous studies have showed the efficacy of removable brace treatment for distal radius buckle fractures in children, whereas others have independently suggested that these injuries do not require additional radiographic imaging. However, no study has sought to collectively determine whether treating pediatric distal radius buckle fractures with a removable brace and no follow-up visit or imaging after the initial visit is a safe and satisfactory protocol. METHODS: In total, 42 consecutive patients with a distal forearm buckle fracture seen by a single fellowship trained pediatric orthopaedic surgeon were eligible to participate...
March 9, 2018: Journal of Pediatric Orthopedics
Mauricio Silva, Gal Sadlik, Tigran Avoian, Edward Ebramzadeh
BACKGROUND: The ideal type of immobilization for nondisplaced pediatric elbow fractures has not been established. We hypothesized that the use of a long-arm cylinder made of soft cast material will result in similar outcomes to those obtained with a traditional long-arm hard cast. METHODS: We randomly assigned 100 consecutive children who presented with a closed, nondisplaced, type I supracondylar humeral fracture or an occult, closed, acute elbow injury, to 1 of 2 groups: group A (n=50) received a long-arm, traditional fiberglass (hard) cast...
April 2018: Journal of Pediatric Orthopedics
La Vonne A Downey, Leslie S Zun, Paul Dismukes, Amanda Hong
BACKGROUND: Recent studies have shown that there is a high rate of post traumatic stress disorder in the inner city. OBJECTIVE: The purpose of this study was to determine whether patients in the Emergency Department would use a post traumatic stress disorder (PTSD) assessment. Additionally, did the type of administration of the PTSD tool impact the usage of PTSD services? METHODS: The sample population was taken from patients, 12 years or older, who presented with a non psychiatric illness...
February 2018: Journal of the National Medical Association
Kimberley Jacobs, Molly Posa, Whitney Spellicy, Jaclyn Otero, Maria Kelly
BACKGROUND: Pediatric exposure to influenza-infected adult caregivers (AC) is a significant risk factor for developing influenza. Poor access to vaccines contributes to low adult vaccination rates. We offered adult vaccination at regularly scheduled pediatric office visits and examined barriers to improve future vaccination rates. METHODS: Via a retrospective chart review, we identified ACs who received an influenza vaccination at one of three pediatric clinics within an academic center from August 2015 to May 2016...
March 2, 2018: Pediatric Infectious Disease Journal
Nadine A Kasparian, Richard De Abreu Lourenco, David S Winlaw, Gary F Sholler, Rosalie Viney, Edwin P E Kirk
PurposeAs the molecular basis of congenital heart disease (CHD) comes into sharper focus, cardiac genetics services are likely to play an increasingly important role. This study aimed to identify parents' preferences for, and willingness to participate in, clinical genetics services for CHD.MethodsA discrete choice experiment was developed to assess parents' preferences for pediatric cardiogenetics services based on four attributes: appointment format, health professionals involved, waiting time, and information format...
March 1, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Amitha Prasad Gumidyala, Rachel N Greenley, Jill M Plevinsky, Natasha Poulopoulos, Jose Cabrera, Diana Lerner, Joshua D Noe, Dorota Walkiewicz, Steven Werlin, Stacy A Kahn
Background: Inflammatory bowel diseases (IBD) often begins early in life. Adolescents and young adults (AYA) with IBD have to acquire behaviors that support self-care, effective healthcare decision-making, and self-advocacy to successfully transition from pediatric to adult health care. Despite the importance of this critical time period, limited empirical study of factors associated with transition readiness in AYA exists. This study aimed to describe transition readiness in a sample of AYA with IBD and identify associated modifiable and nonmodifiable factors...
February 15, 2018: Inflammatory Bowel Diseases
Thuy Thanh Frakking, John Waugh, Hsien-Jin Teoh, Doug Shelton, Susan Moloney, Donna Ward, Michael David, Matthew Barber, Hannah Carter, Sharon Mickan, Kelly Weir
BACKGROUND: Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden...
February 19, 2018: BMC Pediatrics
Carolyn Bridgemohan, Nerissa S Bauer, Britt A Nielsen, Anne DeBattista, Holly S Ruch-Ross, Linda B Paul, Nancy Roizen
BACKGROUND AND OBJECTIVES: Developmental-behavioral conditions are common, affecting ∼15% of US children. The prevalence and complexity of these conditions are increasing despite long wait times and a limited pipeline of new providers. We surveyed a convenience sample of the developmental-behavioral pediatric (DBP) workforce to determine current practices, workforce trends, and future needs. METHODS: An electronic survey was e-mailed to 1568 members of the American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities, the Society for Developmental and Behavioral Pediatrics, and the National Association of Pediatric Nurse Practitioners Developmental and Behavioral Mental Health Special Interest Group...
February 16, 2018: Pediatrics
Marisa E Hilliard, Cheryl Brosig, Andre A A Williams, Jessica Valenzuela, Astrida Kaugars, Paul M Robins, Peggy Christidis, Karen E Stamm, Tim Wysocki
Little is known about the career satisfaction of pediatric psychologists, who specialize in psychological research, teaching, and clinical service in the context of pediatric healthcare. As part of the larger Society of Pediatric Psychology Workforce Survey and in collaboration with the American Psychological Association Center for Workforce Studies, this study aimed to: (1) describe the career domains which pediatric psychologists perceive to be important and their satisfaction in each domain, and (2) compare satisfaction of pediatric psychologists across work settings, number of positions, appointment duration, professional roles, career stage, academic rank, and gender...
December 2017: Professional Psychology, Research and Practice
Laurel Chiappetta, Stacy Stark, Khadejah F Mahmoud, Kyle R Bahnsen, Ann M Mitchell
Motivational interviewing (MI) is a therapeutic technique that has been demonstrated to increase adherence to various treatment regimens. Nonattendance at outpatient appointments is associated with read-mission to psychiatric hospitals. The purpose of the current study was to examine the effectiveness of MI in promoting treatment adherence and increasing pediatric attendance rates at patients' first follow-up appointment after inpatient admission. A sample of 111 patients discharged from one of two child and adolescent units at an urban, inpatient psychiatric hospital in Southwestern Pennsylvania participated in the MI discharge process...
February 15, 2018: Journal of Psychosocial Nursing and Mental Health Services
Christina E Holbein, Aimee W Smith, James Peugh, Avani C Modi
Objectives: To describe allocation of treatment responsibility (ATR) in adolescents with epilepsy, investigate associations between cognitive skills and ATR, and examine whether ATR for antiepileptic drugs (AEDs) predicted electronically monitored adherence. Method: Sixty adolescents with epilepsy and their caregivers completed the Allocation of Treatment Responsibility Scale and a battery of self-report measures. Medical chart review data and electronically monitored AED adherence were collected for 1 year...
February 13, 2018: Journal of Pediatric Psychology
Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
Brooke L Gildon, Barnabas John, Michelle Condren, Shellie Keast, Roxanne Maglunog, Jeremy L Johnson, Christopher Robertson
OBJECTIVES: To use a pharmacist-managed short-acting beta agonist (SABA) service (1) to determine the patient's rationale for SABA refill requests, (2) to assess adherence to current controller therapy and current level of disease control, and (3) to characterize the pharmacist's recommendations made in response to a patient's SABA refill request. SETTING: An academic-based general pediatric clinic. PRACTICE DESCRIPTION: SABA overuse is a marker of increased morbidity and mortality in children with asthma...
February 3, 2018: Journal of the American Pharmacists Association: JAPhA
Kris P Rehm, Mark S Brittan, John R Stephens, Pradeep Mummidi, Michael J Steiner, James C Gay, Soleh Al Ayubi, Nitin Gujral, Vandna Mittal, Kelly Dunn, Vincent Chiang, Matt Hall, Kevin Blaine, Margaret O'Neill, Sarah McBride, Jayne Rogers, Jay G Berry
BACKGROUND: Many hospitals are considering contacting hospitalized patients soon after discharge to help with issues that arise. OBJECTIVE: To (1) describe the prevalence of contactidentified postdischarge issues (PDI) and (2) assess characteristics of children with the highest likelihood of having a PDI. DESIGN, SETTING, PATIENTS: A retrospective analysis of hospital-initiated follow-up contact for 12,986 children discharged from January 2012 to July 2015 from 4 US children's hospitals...
February 2, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Sharon Clark, Debbie Emberly, Kathleen Pajer, Emily Delong, Susan McWilliam, Alexa Bagnell, Sabina Abidi, Barbara Casey, William Gardner
Objective: The Choice and Partnership Approach (CAPA) is designed to improve access and quality of pediatric mental health care. We tested whether CAPA improved access in an academic pediatric hospital. Method: We used de-identified administrative data to compare access pre- (2011) and post-CAPA (2013). Results: Wait time to first appointment in 2011 was 225.3 days (95% CI = [211.0, 239.6], N = 364), compared to 93.0 days (95% CI = [89.2, 96...
January 2018: Journal of the Canadian Academy of Child and Adolescent Psychiatry
Olivier Drouin, Jonathan P Winickoff
BACKGROUND/OBJECTIVE: Unhealthy behaviors are a major cause of chronic disease. Pre-appointment screening has been suggested as one way to improve preventive care delivery related to these behaviors by specifying risks to be addressed. We aimed to determine whether screening for health-related behaviors before the clinical encounter will lead to higher counseling rate and service delivery by clinicians. METHODS: We used a pre-/post-design in one practice with a control practice to evaluate the effects of pre-appointment screening for three behavioral risk factors (tobacco smoke exposure, no recent dental care visit, and consumption of sugar-sweetened beverages)...
January 20, 2018: Academic Pediatrics
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